News
The Removal of Tubes, Intravenous Lines, Cannulae, etc
AAPT has been asked to comment on the removal of various tubes and lines from the deceased particularly before their release to funeral directors.
AAPT has been asked to comment on the removal of various tubes and lines from the deceased particularly before their release to funeral directors.
Following Death
It is essential that any tubes, lines, etc are left in situ if the deceased is for post-mortem examination. This will allow the pathologist to confirm that such devices have been applied appropriately and lie in the correct position. All lines and devices are removed as part of the post-mortem examination process though some intravenous lines may be left in situ to avoid potential leakage in storage and subsequent transportation i.e. IV cannulae in ante cubital fossa. Of course the majority of deaths that occur in hospital do not require post-mortem examination and this raises the question as to whether or not such devices should be removed or left in situ.
Having consulted experienced mortuary managers it is clear that most agree that such devices should remain in situ. The primary reason for this is to minimise the risk of leakage of body fluids (principally blood). Experience suggests that the removal of lines can and does cause leakage problems that are undesirable from an aesthetic and infection control viewpoint.
AAPT therefore recommend that when a patient dies in hospital and various tubes and lines are present that they should remain in situ unless specific local policy has been developed following consultation with all stakeholders.
Viewing by Relatives
APTs may need to remove some devices i.e. Endo-tracheal tubes if the deceased patient is to be viewed by relatives. If there is a possibility that a post-mortem examination is required then the pathologist who will be conducting the examination must be consulted before such devices are removed.
Release to Funeral Directors
AAPT is aware that there is significant variation nationally as to whether or not lines, etc are removed before the deceased is released into the care of the Funeral Director. It would appear that in many areas there exists local agreement between the funeral profession and the mortuary that such devices should remain in situ to minimise the risk of leakage. Some Funeral Directors actually prefer various lines to be left in situ especially if the deceased is to be embalmed.
AAPT recommend that mortuaries communicate with their local pathologist, coroners/procurator fiscal, faith leaders and funeral directors to establish systems and practices that is acceptable to all stakeholders.